Evaluation of nasal optiflow device in management of COPD patients in acute exacerbations

Saeed, Adel M.; Wagih, Khaled; Huusein, Nasra

doi:10.1183/13993003.congress-2015.pa2170

Cited by 3 publications

(7 citation statements)

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“…Only one small RCT reported on ICU LOS in patients with chronic respiratory illnesses which showed a signi cant reduction in favour of HFNO (mean difference= -1.58 days, 95% CI= -2.28 days to -0.88 days; p < 0.001; n = 45 participants) (73). This signi cant reduction remained with the inclusion of an additional observational study in secondary analysis(72) (Supplementary Fig.…”

Section: Other Hospitalisation-related Outcomesmentioning

confidence: 98%

“…Of the 10 RCTs, 6 (60%) reported no signi cant difference in change in PaCO 2 when comparing HFNO to COT use in patients with acute respiratory illnesses(42,44,57, 66, 68,71) (Supplementary Table11a). All 4 RCTs that reported a signi cant difference in change in PaCO 2 at one or more timepoints during the study were in favour of HFNO(6,35, 67,73). In patients with chronic respiratory illnesses, 3 of 5 RCTs (60%) reported no signi cant reduction in PaCO 2 levels in patients receiving HFNO compared to COT(66, 68, 71) (Supplementary Table11b).…”

mentioning

confidence: 99%

“…In patients with chronic respiratory illnesses, 3 of 5 RCTs (60%) reported no signi cant reduction in PaCO 2 levels in patients receiving HFNO compared to COT(66, 68, 71) (Supplementary Table11b). Both RCTs that reported a signi cant difference in change in PaCO 2 at one or more timepoints were in favour ofHFNO(67,73). Secondary analyses of pooled data from all studies identi ed similar ndings for patients with acute respiratory illnesses with most studies (20 of 30, 67%) reporting no signi cant difference in change in PaCO 2 levels when comparing HFNO to COT(3, 5, 7, 31, 42-45, 49-51, 54, 56, 57, 60, 61, 65, 66, 68, 71).…”

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confidence: 99%

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High flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis

Seow

Khor

Khung

et al. 2023

Preprint

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Background This systematic review aims to summarise the evidence regarding any benefits of high flow nasal oxygen (HFNO) therapy compared to conventional oxygen therapy (COT) in hospitalised patients with acute or chronic respiratory illnesses. Methods A comprehensive search was performed across three databases for studies that reported any of: escalation to invasive mechanical ventilation (IMV), mortality, length of stay, carbon dioxide levels, disability, or admission rates. Results In patients with acute respiratory illnesses, pooled RCT data revealed no significant differences between HFNO and COT in overall need for IMV (RR = 0.82, 95% CI = 0.65–1.05; p = 0.11; n = 15 RCTs) or in-hospital mortality (RR = 1.00, 95% CI 0.85–1.17; p = 1.00; n = 5). Similarly, for patients with chronic respiratory illnesses, RCT data revealed no significant difference in overall need for IMV (RR = 0.86, 95% CI = 0.33–2.23; p = 0.76; n = 4) or in-hospital mortality (RR = 0.40, 95% CI = 0.04–4.10; p = 0.44; n = 1) for HFNO compared to COT. Patients with COVID-19 receiving HFNO had a significantly reduced need for IMV (RR = 0.72, 95% CI = 0.63–0.82; p < 0.001), short-term mortality (RR = 0.62, 95% CI = 0.48–0.79; p < 0.001), and long-term mortality (RR = 0.67, 95% CI = 0.48–0.92; p = 0.01). Conclusion HFNO did not significantly reduce the need for IMV escalation or in-hospital mortality in patients with acute or chronic respiratory illnesses, except for patients with COVID-19.

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Section: Other Hospitalisation-related Outcomesmentioning

confidence: 98%

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confidence: 99%

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confidence: 99%

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High flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis

Seow

Khor

Khung

et al. 2023

Preprint

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“…Since Optiflow device was in marketing, the physician used it instead CPAP for COPD [1][2][3][4] and heart failure [6], sleep apnea syndrome [7,8] and in newborn infants [9].…”

Section: Optiflow In Internal Medicinementioning

confidence: 99%

“…In respiratory therapy, which was a revolutionary therapy and one of the most exciting developments since the introduction of noninvasive ventilation? In internal medicine, the physicists used this device to treat central sleep apnea and COPD, respiratory failure and heart failure patient instead of CPAP [1][2][3][4]. In recent years there were some publication about Optiflow could enhance the apnea time for intubation and also increased the outcome in postextubation [5].…”

Section: Introductionmentioning

confidence: 99%

Anesthesia New Century-Optiflow in Anesthesia- You may use NMJB without Endotracheal Tube or LMA and only with Nasal Cannula

Ho¹

2018

JAICM

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High-flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis

Seow,

Khor,

Khung

et al. 2024

BMJ Open Resp Res

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BackgroundHigh-flow nasal oxygen therapy (HFNO) is used in diverse hospital settings to treat patients with acute respiratory failure (ARF). This systematic review aims to summarise the evidence regarding any benefits HFNO therapy has compared with conventional oxygen therapy (COT) for patients with ARF.MethodsThree databases (Embase, Medline and CENTRAL) were searched on 22 March 2023 for studies evaluating HFNO compared with COT for the treatment of ARF, with the primary outcome being hospital mortality and secondary outcomes including (but not limited to) escalation to invasive mechanical ventilation (IMV) or non-invasive ventilation (NIV). Risk of bias was assessed using the Cochrane risk-of-bias tool (randomised controlled trials (RCTs)), ROBINS-I (non-randomised trials) or Newcastle-Ottawa Scale (observational studies). RCTs and observational studies were pooled together for primary analyses, and secondary analyses used RCT data only. Treatment effects were pooled using the random effects model.Results63 studies (26 RCTs, 13 cross-over and 24 observational studies) were included, with 10 230 participants. There was no significant difference in the primary outcome of hospital mortality (risk ratio, RR 1.08, 95% CI 0.93 to 1.26; p=0.29; 17 studies, n=5887) between HFNO and COT for all causes ARF. However, compared with COT, HFNO significantly reduced the overall need for escalation to IMV (RR 0.85, 95% CI 0.76 to 0.95 p=0.003; 39 studies, n=8932); and overall need for escalation to NIV (RR 0.70, 95% CI 0.50 to 0.98; p=0.04; 16 studies, n=3076). In subgroup analyses, when considering patients by illness types, those with acute-on-chronic respiratory failure who received HFNO compared with COT had a significant reduction in-hospital mortality (RR 0.58, 95% CI 0.37 to 0.91; p=0.02).DiscussionHFNO was superior to COT in reducing the need for escalation to both IMV and NIV but had no impact on the primary outcome of hospital mortality. These findings support recommendations that HFNO may be considered as first-line therapy for ARF.PROSPERO registration numberCRD42021264837.

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Evaluation of nasal optiflow device in management of COPD patients in acute exacerbations

Cited by 3 publications

References 0 publications

High flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis

High flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis

Anesthesia New Century-Optiflow in Anesthesia- You may use NMJB without Endotracheal Tube or LMA and only with Nasal Cannula

High-flow nasal oxygen therapy compared with conventional oxygen therapy in hospitalised patients with respiratory illness: a systematic review and meta-analysis

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